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Diagnostic accuracy of T-cell interferon-gamma release assays in tuberculous pleurisy: a meta-analysis.
MedLine Citation:
PMID:  21299686     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
SUMMARY AT A GLANCE: A meta-analysis was performed to establish the overall diagnostic accuracy of T cell IFN-γ release assays for tuberculous pleurisy. The current evidence does not support the use of T cell IFN-γ release assays on either pleural fluid or blood, for the diagnosis of tuberculous pleurisy. ABSTRACT: Background and objective:  The diagnosis of tuberculous pleurisy by analysis of pleural fluid using standard diagnostic tools is difficult. Recently, T cell interferon-gamma release assays (IGRAs) have been introduced for the diagnosis of tuberculous pleurisy. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of IGRAs on both pleural fluid and peripheral blood, for diagnosing tuberculous pleurisy. Methods:  A systematic review was performed of English language publications. Sensitivity, specificity, and other measures of the accuracy of IGRAs for the diagnosis tuberculous pleurisy using both pleural fluid and blood, were pooled using a random-effects model or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance. Results:  Seven out of eight studies met the inclusion criteria. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and diagnostic odds ratio were, for pleural fluid: 0.75, 0.82, 3.49, 0.24, 0.85, 0.70, and 19.04, respectively; and for blood: 0.80, 0.72, 2.86, 0.28, 0.78, 0.74, and 11.06, respectively. Conclusions:  Since almost 20% of non-tuberculosis patients would be erroneously treated for tuberculosis and 25% of patients with tuberculous pleurisy would be missed, pleural fluid IGRAs are not useful for the clinical diagnosis of tuberculous pleurisy.
Authors:
Qiong Zhou; Yi-Qiang Chen; Shou-Ming Qin; Xiao-Nan Tao; Jian-Bao Xin; Huan-Zhong Shi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.
Affiliation:
Department of Respiratory Diseases, Union Hospital, Key Lab of Pulmonary Diseases of Health Ministry, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, and First Affiliated Hospital, Guangxi Medical University, Nanning, China.
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